Measles surge threatens U.S. elimination status amid outbreaks

A year after a west Texas cluster ignited the largest U.S. measles outbreak in decades, the virus continues to circulate across the country, raising the prospect that the United States could lose its long-held elimination status. Health authorities report new cases weekly into early 2026, with clusters now spanning multiple regions and settings.

The initial cluster began in Gaines County, Texas, on Jan. 20, 2025 and expanded into a statewide crisis that exceeded 760 cases before officials declared that outbreak over in August 2025. Nationwide, 2,242 confirmed measles cases were recorded in 2025, the highest annual total since 1992. The Centers for Disease Control and Prevention reported 171 confirmed cases so far in 2026 as of Jan. 13, across nine states, and public-health experts say roughly 96 percent of those 2026 cases trace back to outbreaks that started in 2025.

Large localized outbreaks continue to drive community spread. An upstate South Carolina outbreak has grown to more than 550 cases. A multi-jurisdiction outbreak along the Utah-Arizona border has amassed hundreds of cases and remains active. Local health departments report exposures in schools, churches, restaurants, shops, airports and other community gathering places during the first two weeks of 2026, increasing the risk to children and adults who remain unvaccinated or underimmunized.

The human toll has been severe. More than 150 children were hospitalized with measles in 2025, and three deaths were recorded last year: two unvaccinated children and one adult. Public-health authorities caution that measles can be fatal, with an approximate risk of one death per 1,000 cases, and that higher case counts translate directly into more hospitalizations and preventable deaths.

Public-health officials point to low vaccination coverage as the central driver of the resurgence. For 2025, about 93 percent of cases occurred in people who were unvaccinated or whose vaccination status was unknown, according to compiled health data. The CDC has not formally confirmed that the west Texas virus is genetically linked to every subsequent outbreak nationwide, nor has it declared continuous, uninterrupted transmission across the U.S. for a full 12 months. Still, state and local officials have documented specific linkages: David Heaton, public information officer at the Southwest Utah Department of Public Health, said cases in southwest Utah and further north have been linked to the same measles virus that spread in Texas and New Mexico last year.

Experts warn that the surge signals broader system strains. Dr. Caitlin Rivers of Johns Hopkins described the situation as “startling,” adding that in a single week the U.S. is seeing what might once have been a year’s worth of cases. Dr. Demetre Daskalakis, a former CDC official, said measles elimination is “a vital sign of our public health system,” and characterized the system as seriously stressed.

The Pan American Health Organization has invited the United States and Mexico to a virtual review meeting on April 13, 2026 to determine whether the U.S. still meets elimination criteria, which require an absence of continuous endemic transmission for more than 12 months in the presence of adequate surveillance. International context matters: Mexico reported more than 5,900 cases last year, and Canada previously lost elimination status after a yearlong outbreak. Losing formal elimination status would underscore longstanding gaps in vaccine coverage, access and outbreak control. Public-health leaders say restoring the gains would be possible but could take years and would demand sustained investments in equitable vaccination, surveillance and community engagement.